AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #124 - Can we rely on community-participatory methods to target cash transfer programmes to vulnerable households and children in high HIV prevalence and low resource contexts? A case study from Manicaland, Zimbabwe
Authors: Presenting Author: Ms Laura Robertson - Imperial College London
Additional Authors: Ms. Phyllis Mushati, Prof. Lorraine Sherr, Mr. JC Makoni, Prof. Tom Crea, Mr. Gideon Mavise, Mr. Lovemore Dumba, Dr. Christina Schumacher, Mr. Jeffrey Eaton, Dr. Constance Nyamukapa, Prof. Simon Gregson,
Aim: Cash transfer programmes use a variety of methods to target vulnerable households and children. These include wealth indices and dependency ratios calculated from data on household assets and residents collected in local censuses and community-participatory methods (including wealth ranking exercises). Detailed household surveys are costly and time-consuming to conduct, especially in resource poor settings; therefore, targeting often relies heavily on community-based approaches. We assessed the effectiveness of alternative approaches to targeting for a cash transfer programme for orphans and vulnerable children (OVC) in Manicaland, Zimbabwe.
Method / Issue: We analysed data from 10,536 households caring for children enumerated in a census in September 2009 in Manicaland, Zimbabwe, for the baseline of a community-randomised controlled trial of cash transfers for households caring for OVC. These data provide information on the demographic structure of households (including dependency ratios), household assets and other indicators of vulnerability (e.g. orphan status of children in the household, disability and illness of household members) and baseline data on the primary outcomes for the trial (vaccinations, school attendance and birth registration). Data from a community-based participatory wealth ranking (PWR) procedure conducted in the same communities and a community verification exercise of the household census data were also examined. We compared the vulnerability of households and children that would be targeted by each method.
Results / Comments: There was a weak correlation between the ranking of households according to the community PWR procedure and the wealth index based on census reports on household assets (Kappa statistic = 0.28). Being ranked in the poorest category in the PWR exercise and having a high dependency ratio were significantly associated with other household-level vulnerability characteristics (e.g. having a female household head). However, being ranked in the poorest households according to the asset-based wealth index was not associated significantly with other indicators of household-level vulnerability. Children living in households identified as poor by both PWR and the wealth index suffered more statistically significant negative outcomes (e.g. primary and secondary school enrolment, birth registration). Dependency ratios showed fewer associations with child-level vulnerability characteristics. Much stronger correlations were found between household census information and the data collected during the community verification exercise for types of household vulnerability aside from poverty (e.g. disabled household members; Kappa statistics greater than 0.5). Vulnerable households, as identified from the census (not using wealth data), were more likely to have high dependency ratios and children aged 13-17 years living in the households were less likely to be enrolled in secondary school.
Discussion: Census data and community participatory methods show success in identifying vulnerable children. Community participatory methods of identifying poor households tend to also target more visible forms of vulnerability than poverty (e.g. caring for orphans, chronically ill household members) and children living in vulnerable households are more likely to suffer adverse educational and social outcomes. However, there may be problems associated with ensuring complete enumeration of all households when community-based methods of targeting are used.
Go Back